Patient Forms
Thank you for choosing The Center for Behavioral Medicine as your provider for behavioral health services. Please complete and return the necessary paperwork to our office (1260 North Dutton Avenue Suite 100 Santa Rosa, CA 95401) , at least 30 minutes prior to your first appointment.
New patients should submit the following questionnaires/forms:
- Adult Intake Form (if applicable)
- Child/Teen Intake (if applicable)
- Current Medication Record
- Consent to Release Information
If you have any questions about our questionnaires/forms, please feel free to contact our office by calling (650) 856-0406.
